Surgical Neck Fractures Of Humerus Research Articles

Osteomyelitis with abscess associated with acute closed upper humerus fracture in an adult: A case report

Key Clinical MessageA 64‐year‐old female presented with malaise and fever 11 days after a closed, minimally displaced humerus surgical neck fracture. MR imaging revealed an abscess around the fracture, which is a very rare occurrence in adults. Two open debridements and IV antibiotics eradicated the infection. Reverse total shoulder arthroplasty was eventually performed for fracture nonunion.

Comparison of intramedullary nail and plate osteosynthesis in humerus surgical neck fracture.

The aim of this study is to compare clinically and radiologically the plate osteosynthesis method and the in-tramedullary nail (IMN) method, which is currently used in the surgical treatment of surgical neck proximal humerus fractures (PHFs) in which there is no consensus METHODS: A total of 248 patients who underwent PHF between January 2013 and December 2017 were retrospectively reviewed. Sixty-two patients were included in the study. The results were clinically compared in terms of the amount of blood loss, operative time, and union time. Radiologically, it was compared in terms of intraoperative neck-shaft angle (NSA), final NSA, the American Shoulder and Elbow Surgeons (ASES), and Constant and Visual Analog Scale (VAS) scores. Two groups were formed: plate and IMN. The groups were similar in terms of age, sex, operation side, and follow-up time. There was no difference between the groups in terms of NSA, final NSA, ASES, Constant, and VAS scores. The amount of intraoper-ative blood loss, operative time, and union time was shorter in the IMN group. In surgical neck PHF surgery, plate and IMN are methods that show good clinical outcomes. According to this study, the advantages of the IMN method compared with plate osteosynthesis in Neer type II PHF treatment can be listed as less intraoper-ative blood loss, shorter operative time, and union time.

Treatment of the surgical neck fracture of the humerus with a novel external fixator in the elderly with osteoporosis: biomechanical analysis

BackgroundNo consensus exists on the treatment of proximal humerus fractures, especially in the elderly patients with osteoporosis. This study was aimed to evaluate the biomechanical characteristics of a novel external fixator in treating two-part surgical neck fracture of the proximal humerus in the elderly patients with osteoporosis.MethodsSixteen female elderly humeral shaft specimens with osteoporosis were randomized into 2 groups. Models with the surgical neck two-part fracture of the proximal humerus were built, in which a novel external fixator (test group) and a clover plate (control group) were applied separately. In the test group, the fracture was firstly fixed with intersection pinning using 3 Schanz pins (3.5 mm), followed by the novel external fixation frame. In the control group, a clover plate and 6 cortical bone screws were applied. Biomechanical testing of the specimens was performed to assess the resistance to load bearing and torsional stress. The parameters of the two groups were compared using independent t-test.ResultsUltimate bearing capacity and load bearing at different parts with the humerus rotation were higher (P < 0.05) in the external fixator group (145.16 ± 17.42 N and 140 N respectively) than those in the plate group (120.21 ± 13.15 N and 69.63 ± 25.16–90.78 ± 17.18 N respectively). As for resistance to torsional stress, plate’s torque fluctuated between 1 Nm and 5 Nm, while the external fixator’s torque values were more evenly (P < 0.01) distributed with the fluctuation within 1 Nm.ConclusionsIn the fixation of two-part humeral fracture in elderly patients with osteoporosis, the new external fixator seemed to be superior to plate fixation in load bearing and resistance to torsional stress.

Floating needle therapy for postoperative functional rehabilitation in patients with surgical neck fracture of humerus: a randomized controlled trial

To compare the effect of floating needle therapy on myofascial trigger point (MTrP) and conventional electroacupuncture on the recovery of shoulder joint function after surgical neck fracture of humerus on the basis of drugs and rehabilitation training. A total of 72 patients with unilateral surgical neck fracture of humerus were randomly divided into a floating needle group (35 cases) and an electroacupuncture group (37 cases). At the same time of the basic treatment, both groups were intervened on the 2nd day after operation. Touched the MTrP at the affected limb, and the floating needle was used to sweep around it in the floating needle group. In the electroacupuncture group, electroacupuncture was applied at Hegu (LI 4), Quchi (LI 11), Waiguan (TE 5) on the affected side, the dilatational wave (4 Hz/20 Hz) was selected. The treatment was given once every day for 2 weeks. Pain visual analogue scales (VAS) score, constant shoulder joint score, and changes in the number of MTrP were used to evaluate the pain and functional status of the shoulder joints before, after treatment, and 3 months after treatment. Compared with that before treatment, the VAS scores were decreased, the constant scores were increased, and the numbers of MTrP were decreased in the two groups after treatment and 3 months after treatment (P<0.05), but the improvement in the floating needle group was better than that in the electroacupuncture group (P<0.05). Compared with that after treatment, the VAS scores were decreased and the constant scores were increased 3 months after treatment in the floating needle group (P<0.05), and the VAS scores in the electroacupuncture group were decreased (P<0.05). Floating needle therapy is helpful for the rehabilitation of shoulder joint function after surgical neck fracture of the humerus, and its curative effect is better than conventional electroacupuncture.

Modified Mclaughlin procedure combined with locking plate for posterior shoulder dislocation with fracture

To study clinical effects of modified Mclaughlin procedure combined with locking plate for posterior shoulder dislocation with proximal humeral fracture which area of femoral head injury less than 40%. From July 2012 to June 2017, 7 patients with posterior shoulder dislocation were treated, including 5 males and 2 females; aged from 37 to 53 years old. Three patients combined with split of humerus head and 4 patients combined with humerus surgical neck fracture. All patients treated with modified Mclaughlin procedure combined with locking plate. Motion of shoulder joint after operation was observed, postoperative UCLA score was used to evaluate clinical effects. Seven patients were followed up from 10 to 33 months. The motion of anteflexion and up-lift ranged from 130° to 170°, the motion of extorsion ranged from 45° to 75°, the motion of abduction ranged fron 105° to 150°, and the internal rotation was between L₃ to buttock. UCLA score ranged from 29 to 34; and 1 patient reached excellent, and 6 patients good. The modified Mclaughlin procedure combined with locking plate showed satisfying result for posterior shoulder dislocation combined with fractures. However, the internal rotation of shoulder could be compromised.

Two cases of radial nerve palsy after intramedullary nailing for surgical neck fracture of humerus

Two cases of radial nerve palsy after intramedullary nailing for surgical neck fracture of humerus

Fracture of Proximal Humerus in the Lateral Anchor Site after Suture Bridge Repair: A Case Report

To report the fracture of proximal humerus in the lateral anchor site after suture bridge repair. A 57-year-old female patient with shoulder pain on the right-side was admitted through the emergency room following a car accident. Seven weeks before the accident, the patient had undergone surgery at a different hospital for the repair of supraspinatus tendon rupture on the right-side via suture bridge technique. Humerus surgical neck fracture was confirmed by X-ray, and proximal humerus fracture at the anchor site was confirmed by magnetic resonance imaging. Following 7 months of conservative treatment resulted in satisfactory bone union and motion of the shoulder joint. We report the need of close observation during and after the arthroscopic repair of the rotator cuff in patients with osteoporosis.

Clinical effects of splint of the embedded cross shoulder strap for the treatment of humerus surgical neck fractures

Objective To research the clinical effects of splint of the embedded cross shoulder strap for the treatment of humerus surgical neck fractures.Methods 118 patients in our hospital with orthopedic humerus surgical neck fracture by external fixation after manipulative reduction were randomly divided into the embedded cross shoulder strap splint for the treatment group and routine treatment group.The treatment group with 59 cases used the cross strap small splint external fixation treatment,the conventional treatment group with 59 patients used the textbook four block of small splint external fixation method of comparative analysis,clinical efficacy of two groups were analyzed and compared.Results Among treatment group and routine treatment group,the small splinting loose,fractures,deformities,pain,swelling and alleviate the symptoms before and after treatment and the clinical healing efficacy,late recovery of shoulder joint function were followed up for three months of treatment,showing significant difference (P＜0.01).Fracture healing clinical curative effect,the total effective rate of treatment group was 94.9％,the total efficiency in control group was 79.6％.The treatment group was better than control group (P＜0.01).Conclusions Application of the embedded cross shoulder strap splint for the treatment of humerus surgical neck fracture,can comfort and finn fixation,avoid and reduce the displacement of fractures,with better early symptoms efficacy and significant clinical effect,it can also improve patients' satisfaction,worthy of clinical application. Key words: Splint of the embedded cross shoulder strap; External fixation; Humerus surgical neck fractures

Treatment of humerus surgical neck fracture with interlocking intramedullary nail versus locking plate

Objective To compare efficacy between the interlocking intramedullary nail and the locking plate in the treatment of humerus surgical neck fractures.Methods From January 2003 through June 2008,36 patients with humerus surgical neck fracture were randomized into an interlocking intramedullary nail group (21 cases ) and a locking plate group ( 15 cases).They were 11 males and 25 females,with an average age of 60.3 years (range,26 to 78 years).According to the Neer system,there were 6 cases of type Ⅱ,13 cases of type Ⅲ and 2 cases of type IV in the nail group,while there were 4 cases of type Ⅱ,8 cases of type Ⅲ and 3 cases of type IV in the plate group.The data of wound length,operative time,intra-operative blood loss,fracture healing time and functional recovery were recorded and analyzed statistically.Results The follow-up periods ranged from 6 to 24 months (average,15.3 months).There were significant differences between the 2groups( P ＜ 0.05 ) in wound length,operative time and intra-operative blood loss,but the average fracture healing time was not significantly different between the groups( P ＞ 0.05).The functional recovery was better in the intramedullary nail group than in the locking plate group but with no significance( P ＞ 0.05).Conclusion Although both theinterlocking intramedullary nail and the locking plate are similarly effective in the treatment of humerus surgical neck fractures,the former has an advantage in operative invasion and manipulative simplicity. Key words: Hurneral fractures, proximal; Fracture fixation, internal; Treatment outcome

Rupture of the Conjoined Tendon and the Long Head of the Biceps Brachii Tendon Accompanied by Surgical Neck Fracture of Humerus -A Case Report-

Rupture of the Conjoined Tendon and the Long Head of the Biceps Brachii Tendon Accompanied by Surgical Neck Fracture of Humerus -A Case Report-

Polarus 골수정을 이용한 상완골 경부 불유합의 수술적 치료

Purpose: Evaluate the clinical results of humerus neck nonunion treated with Polarus intramedullary nail. Materials and Methods: 8 patients who underwent surgery for nonunion of humerus surgical neck fracture were included. All patients were female, the average age was 65 years. 5 out the total 8 cases initially received surgery, open reduction and internal fixation with metal plate in 1 case, Ender nail insertion in 2 cases, external fixator in 1 case and closed reduction and percutaneous pinning in 1 case. The other 3 non union cases initial received conservative managemnent. The average period of nonunion was 9 months in the operated group and 6.2 months in the conservative group. All 8 cases received closed reduction with intrameedullary Polarus nail and auto iliac bone graft. Union was confirmed radiologically, and functional evaluation was done with the UCLA functional criteria. Results: All 8 cases showed union on radiologic evaluation. Average time to union was 3.5 months, average follow up period was 27 months. Average UCLA shoulder evaluation score was 7.6 points preoperatively which improved to 26.3 points after surgery. Active shoulder flexion was 40.7 degrees preoperatiely which increased to 104 degrees after surgery. Shoulder abduction improved from 32.9 degrees preoperatively to 96.3 degrees after surgery. UCLA functional criteria was good in 5 cases and fair in 3 cases, which no poor cases. Conclusion: Polarus IM nailing and AIBG is a useful method for treating nonunion of humerus neck fracture with improvement in union and function.

Treatment of Humerus Surgical Neck Fracture with Percutaneous Reduction and Kirschner's Pins Internal Fixation

目的 探讨经皮内固定治疗肱骨外科颈骨折.方法在C臂型X光机透视下,对不稳定性肱骨外科颈骨折采用拔针法复位后,再经皮穿入交叉克氏针作内固定.结果本组32例,达解剖对位者1 2例,近解剖对位者11例,功能对位者9例,均于术后4周内达临床愈合,10周内达骨性愈合;随访9个月～3年,后期疗效优21例,良4例,可5例,差2例.结论经皮撬拔复位、克氏针内固定治疗肱骨外科颈骨折的方法,既能达到良好的复位,又可获得满意的功能,具有痛苦少、治疗时间短、无明显并发症、医疗费用低的优点,是治疗肱骨外科颈骨折较为合理、有效的方法之一。

Premiers résultats du clou Polarus dans le traitement des fractures proximales de l'humérus

The Polarus nail has recently been popularised to fix proximal humeral fractures. In the current pilot study we reviewed the early results obtained using this nail.Ten patients with proximal humeral fracture (four pathological, 5 traumatic and one non-union) were fixed using a Polarus nail. The fractures were classified according to Neer (7 two-parts and 3 three-part fractures). The mean followup was 22 months (6–39) months. The following criteria were assessed: pain, range of shoulder movement and function. Seven patients were satisfied with their operation, their fractures healed in a mean period of 3 months (2–4 months). No postoperative neurovascular complications were encountered; the re-operation rate, was however 30%.Conclusion: in the authors' brief pilot study in 10 patients, and despite the heterogenous fracture types, we came in to conclusion that the indications for using Polarus nail is limited due to the high complications rate associated with the procedure when used for displaced three or four part surgical neck fracture of humerus.

Treatment of Two-part, Displaced Surgical Neck Fracture of the Proximal Humerus with Modified Ender Nail and Tension Band Technique

Operative treatment of two-part, displaced surgical neck fractures of the proximal humerus is used when satisfactory closed reduction cannot be achieved or maintained. Recently, we modified the Ender nails by making an additional hole above the slot for wire incorporation. The purpose of this study was to assess the effects of stabilization of displaced and unstable surgical neck fractures of the humerus by Ender nailing and tension band technique. We reviewed the data of fourteen consecutive patients (10 women and 4 men) who had been treated with Ender nailing and tension band wiring between from Aug 1996 and Oct 1997 at Eulji Medical College Hospital. The average age of patients was 54 years (range, 38 to 79 years), and the average follow-up period was 18 months (range, 12 to 24 months). Bone union was observed at 6.3 weeks (range, 5.5 to 10 weeks), except one case of delayed union. There were no infections and nonunions. The average ranges of shoulder elevation and abduction were 140(100 to 170) and

Displaced surgical neck fractures of humerus treated with pinning

Displaced surgical neck fractures of humerus treated with pinning